Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $758.58 / $3,090.30	Facility		$346.74	$758.58	$3,090.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $75.86 / $263.03	Facility	26	$64.57	$75.86	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $323.59 / $758.58	Professional		$181.97	$323.59	$758.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $75.86 / $218.78	Professional	26	$63.10	$75.86	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $173.78 / $354.81	Professional	TC	$114.82	$173.78	$354.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $194.98 / $346.74	Professional		$138.04	$194.98	$346.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $72.44 / $120.23	Professional	26	$53.70	$72.44	$120.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $138.04 / $208.93	Professional	TC	$95.50	$138.04	$208.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility		$1,380.38	$1,380.38	$1,380.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $407.38 / $602.56	Professional		$218.78	$407.38	$602.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $125.89 / $173.78	Professional	26	$77.62	$125.89	$173.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $275.42 / $426.58	Professional	TC	$154.88	$275.42	$426.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $165.96 / $281.84	Facility		$91.20	$165.96	$281.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $134.90 / $239.88	Professional		$69.18	$134.90	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $426.58 / $1,445.44	Facility		$363.08	$426.58	$1,445.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	26	$128.82	$128.82	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $331.13 / $562.34	Professional		$204.17	$331.13	$562.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $97.72 / $186.21	Professional	26	$70.79	$97.72	$186.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $229.09 / $389.05	Professional	TC	$138.04	$229.09	$389.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $257.04 / $691.83	Professional		$199.53	$257.04	$691.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $89.13 / $190.55	Professional	26	$67.61	$89.13	$190.55
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $169.82 / $512.86	Professional	TC	$131.83	$169.82	$512.86
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $2,511.89 / $2,511.89	Facility		$912.01	$2,511.89	$2,511.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $309.03 / $416.87	Professional		$125.89	$309.03	$416.87
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $213.80 / $316.23	Facility		$77.62	$213.80	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $288.40 / $524.81	Professional		$194.98	$288.40	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $91.20 / $169.82	Professional	26	$67.61	$91.20	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $199.53 / $371.54	Professional	TC	$128.82	$199.53	$371.54